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1001 Reeves Pkwy Lebanon OR 97355-7001 | |
(541) 258-0221 | |
(541) 981-5187 |
Full Name | |
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Speciality | Clinic/center - Primary Care |
Location | 1001 Reeves Pkwy, Lebanon, Oregon |
Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | 1001 Reeves Pkwy Lebanon OR 97355-7001 Ph: (541) 258-0221 |
NPI Number | 1093126385 |
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Provider Enumeration Date | 05/08/2014 |
Last Update Date | 10/13/2022 |
Identifier | Type | State | Issuer |
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1093126385 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |